Sponsors (26)
The bill expands no‑cost in‑network perinatal mental health and SUD coverage, strengthens continuity and telehealth access, but increases insurer/employer costs, delays implementation by two years, and leaves gaps for out‑of‑network care.
Pregnant and postpartum individuals: receive free in‑network mental health and substance use disorder (SUD) care from diagnosis through one year postpartum, removing direct financial barriers to treatment.
Patients who start pregnancy‑related or mental health/SUD treatment: keep access to continuing care after insurer or plan changes because continuity‑of‑care protections are extended.
Pregnant and postpartum people in rural and underserved areas: telehealth visits for covered pregnancy‑related and MH/SUD care are treated as in‑network with no in‑network cost‑sharing, increasing practical access to services.
Insurers and employers (and indirectly taxpayers and middle‑class families): will face higher costs to cover expanded free services, which could lead to higher premiums, increased employer contributions, or reduced benefits elsewhere.
Pregnant and postpartum individuals needing care now: relief is delayed because the law has a two‑year deferred effective date, postponing access to cost‑free services for people who need immediate help.
Pregnant and postpartum individuals using out‑of‑network clinicians: may still face high out‑of‑pocket costs because the rule applies only to in‑network providers.
Based on analysis of 2 sections of legislative text.
Eliminates in‑network cost sharing for mental health and SUD services from pregnancy diagnosis through one year postpartum for group and individual plans, and extends continuity‑of‑care protections.
Official title: To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require that group health plans and health insurance issuers offering group or individual health insurance that provide coverage for mental health services and substance use disorder services provide such services without the imposition of cost-sharing from the diagnosis of pregnancy through the 1-year period following such pregnancy, and for other purposes.
Introduced January 22, 2026 by Gwendolynne S. Moore · Last progress January 22, 2026
Bans cost sharing for in‑network mental health and substance use disorder (SUD) services provided to pregnant and postpartum people from diagnosis of pregnancy through one year after the end of pregnancy, for group and individual health plans, beginning for plan years starting two years after enactment. It also extends continuity‑of‑care protections so pregnant people and those who received treatment while pregnant can continue care after pregnancy, and adds parallel ERISA and Internal Revenue Code provisions to apply the rule across plan types.